Objectives
  • To be able to assess, diagnose and treat patients with complications/toxicities of anticancer therapies

Awareness
  • Recognition that different classes of cancer treatments (cytotoxic, (anti)hormonal, targeted and immunotherapy) are associated with a different spectrum of complications/toxicities

  • Appreciation that toxicities of different anticancer therapies can be overlapping

  • Awareness that newer classes of cancer drug therapy (targeted therapy, immunotherapy) are associated with some complications not seen with more traditional therapies (cytotoxic, (anti)hormonal)

  • Appreciation that organs and body systems can be affected by complications/toxicities with variable frequency, severity and chronicity

  • Recognition that severity and chronicity will have implications for management decisions

  • Awareness that complications/toxicities can be acute or chronic

  • Awareness that complications/toxicities can be temporary or permanent

  • Appreciation that drug interactions can contribute to complications/toxicities of treatment

  • Recognition that clinical assessment is of critical importance in the evaluation of treatment-related adverse events

  • Awareness of the existence of the available diagnostic tests

  • Awareness that the complications/toxicities of treatment can have physical and psychological impacts on the patient

  • Recognition that management is often multidisciplinary

  • Awareness that preventative/prophylactic measures exist for some complications/toxicities

  • Appreciation that complications/toxicities from therapy can impact the deliverability of subsequent anticancer treatment

Knowledge
  • Familiarity with the complications/toxicities associated with classes of anticancer therapy (cytotoxic, (anti)hormonal, targeted and immuno-therapy) and with single agents

  • Familiarity with the frequency with which adverse events occur, how severity can be assessed and the natural history of such events

  • Understanding that prescription, over-the-counter and complementary medicines have the potential to interact with anticancer therapy and thus contribute to adverse events

  • Understanding of the diagnostic approach to complications of therapy, in particular the relevant history, examination and investigational findings

  • Familiarity with the spectrum of therapeutic options available for complications of treatment, including pharmacological and non-pharmacological strategies

  • Knowledge of evolving treatment paradigms for targeted therapy and immunotherapy

  • Understanding that many other healthcare professionals will have a role in the diagnosis and management of the complications/toxicities of treatment, including medical, nursing, pharmacy and allied health personnel

  • Understanding that effective prevention and/or prophylactic strategies can be employed to reduce the frequency and/or severity of some complications/toxicities

  • Familiarity with potential mechanisms of complications/toxicities

  • Familiarity with potential drug interactions contributing to complications/toxicities and the mechanisms of these interactions

  • Familiarity with the psychological impact of treatment-related adverse events and the supportive measures available to the patient

  • Understanding how the complications/toxicities of treatment will impact future delivery of anticancer therapy and when a dose delay, dose modification or treatment cessation may be applied

Skills
  • Ability to contribute actively to a wide variety of presentations of complications/toxicities of different classes of anticancer therapy

  • Ability to perform a thorough history and clinical examination

  • Ability to contribute actively to present patient cases

  • Ability to discuss potential diagnostic investigations including the merits and limitations of the tests

  • Ability to contribute to discussions on management strategies with reference to pharmacological and non-pharmacological methods

  • Ability to discuss the role of other healthcare professionals for each scenario

  • Ability to discuss prophylactic/preventative measures that can be instituted to protect patient safety